Background: Laparoscopic cholecystectomy has many difficulties which include port Insertion, Dissectionof the Calot’s Triangle , Grasping of the Gallbladder , Wall thickness, Adhesion and extraction of theGallbladder. Aim of the Study: To predict how difficult cholecystectomy will be from assessing the patientpreoperatively which, in turn, help in decreasing the risks on the patients and preventing post-operativecomplications. Patients and Methods: A prospective study conducted in the department of General Surgeryat Al-Ramadi Teaching Hospital for the period of nine months from 15th of May 2018 till the 15th of February2019. It included 60 patients, all of them were undergone laparoscopic cholecystectomy for Gallstone. Patientswith common bile duct calculus, dilated common bile duct, current attack of acute cholecystitis, those withabsolute contraindications to laparoscopic cholecystectomy, The data were collected prospectively to predictthe significance of association with patients’ characteristics. The time of operation was calculated from thefirst port site incision until the last port closure. All the intra operative events were recorded. Conversionsto open cholecystectomy were done by median or subcostal laparotomy according to the surgeon’s decisionand each patient’s condition. Results: In this study, the highest proportion of operations was categorizedas easy (58.3%), 28.3% of operations were considered difficult and 13.3% of them were very difficult. Asignificant association (P < 0.05) between operation difficulty and all of the following characteristics: Aging,obesity, history of previous biliary hospitalization, thickened bladder wall, pericholecystic collection, andlarge stones. Conclusions: The difficult laparoscopic cholecystectomy can be predicted preoperativelybased on number of factors, like: obesity, previous biliary admission, gall bladder wall thickness, ultrasoundfindings (stone size and pericholecystic fluid) and aging process, evaluating of such factors minimize thecomplications of laparoscopic cholecystectomy and conversion to the open procedure.
A simple straightforward mathematical method has been developed to cluster grid nodes on a boundary segment of an arbitrary geometry that can be fitted by a relevant polynomial. The method of solution is accomplished in two steps. At the first step, the length of the boundary segment is evaluated by using the mean value theorem, then grids are clustered as desired, using relevant linear clustering functions. At the second step, as the coordinates cell nodes have been computed and the incremental distance between each two nodes has been evaluated, the original coordinate of each node is then computed utilizing the same fitted polynomial with the mean value theorem but reversibly.
The method is utilized to predict
... Show MoreThe research presented to the concept of social isolation through the manifestations of that concept and its works within the theatrical presentation space, and the diversity of directing experiences that the theatrical field benefited from, as contemporary data that contributed to the production of theatrical speech engaging with various levels of different form and content, and this was revealed through the chapters of the research that included The first chapter (the systematic framework), the second chapter (theoretical framework), which included the first topic (formations of social isolation), the second topic (social isolation in the world stage), and resulted in indicators including:
1- Postmodernism produced intellectual appr
this research aims at a number of objectives including Developing the tax examination process and raise its efficiency without relying on comprehensive examination method using some statistical methods in the tax examination and Discussing the most important concepts related to the statistical methods used in the tax examination and showing its importance and how they are applied. the research represents an applied study in the General Commission of taxes. In order to achieve its objectives the research has used in the theoretical side the descriptive approach (analytical), and in the practical side Some statistical methods applied to the sample of the final accounts for the contracting company (limited) and the pharmaceutical industry (
... Show MoreThe contextual clues researcher guide to determine the meaning of the word is likely to several meanings, was contextual clues Dalili in determining the meanings morphological acts whipped in a sermon Alhqhqih.
And meanings are endless on the contrary language words used to express these meanings, we find that one word may be used to express more than one meaning, leading to the phenomenon of semantic possibility.
So it was inevitable that contain language text on the signs designate the reader and listener and researcher to identify the intended meaning, and these signs are contextual clues in the text.
Actual formulas whipped features from other formulas morphological Pkthertha frequent use and the large number of meanings men
This study delves into the realm of advanced cooling techniques by examining the performance of a two-stage parallel flow indirect evaporative cooling system enhanced with aspen pads in the challenging climate of Baghdad. The objective was to achieve average air dry bulb temperatures (43 oC) below the ambient wet bulb temperatures (24.95 oC) with an average relative humidity of 23%, aiming for unparalleled cooling efficiency. The research experiment was carried out in the urban environment of Baghdad, characterized by high temperature conditions. The investigation focused on the potential of the two-stage parallel flow setup, combined with the cooling capability of aspen pads, to surpass the limitat
... Show Moreيحاول البحث دراسة رواية الكاتب الاميركي جوزيف هيلر التي تحمل عنوان "كاتش 22" (1961). وفي تفحص دقيق لمحتويات الرواية نجد ان تركيزها الرئيس هو المشاعر المناهضة للروح العسكرية. ويقدم البحث شخصيات مختلفة في الرواية ويحاول ان يعكس من خلالها المشاعر المناهضة للروح العسكرية. وان البحث ناقش ايضاً تأثيرات التصرفات الخاصة والاحداث الرئيسة التي حدثت في القوة الجوية الاميركية. وتدور القصة بشكل رئيس حول بعض رجال القوة ال
... Show MoreCardiac toxicity can occur during the therapy with several cytotoxic drugs, including 5- Fluorouracil (5- FU). It is an antimetabolite that acts during the S phase of the cell cycle and is activated by thymidine phosphorylase into fluorodeoxyuridylate (5 fluoro 2'deoxyuridine 5'monophosphate, 5-FdUMP) that inhibits thymidylate synthase, thus preventing DNA synthesis that leads to imbalanced cell growth and ultimately cell death. It is still a widely used anticancer drug, since 1957. The present study aimed to evaluate the possible cardio-protective effects of ethanolic artichoke extract (Cynara scolymus L.) against 5-fluorouracil (5-FU) induced cardio-toxicity in rats by evaluating serum levels of Alanine aminotransferase, aspartate amin
... Show MoreOne hundred isolates of Pseudomonas aeruginosa were obtained from patients admitted to Baghdad hospitals, Iraq during the period between May 2018 until July 2018. These isolates were distributed as 15 isolates from blood, 25 isolates from urinary tract infections, 10 isolates from sputum, 12 isolates from wounds, 15 isolates from ear infections, 15 isolates from bronchial wash of patients suffering from respiratory tract infections in addition to 8 isolates from cystic fibrosis patients. The isolates were initially identified by culturing on MacConkey agar, blood agar and P. aeruginosa agar then diagnosed by performing some morphological and biochemical tests. The second diagnosis was done by API 20E system followed by Vitek 2 compact syste
... Show MoreAbstract
This research aims to evaluate the application of the inspectors general of global indicators offices according to the axles (leadership, strategy and planning, employees, partners and resources, process management) and through the assumption main research which states that (there is an application for global indicators to evaluate performance in the offices of the ministries under study) which are subdivided into five sub-hypotheses according to the classification and division of the five axes of the checklist.
The researchers have taken refuge in the process of assessing the performance of the check list which included global i
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